Authorization Specialist II

Immediate need for a talented Authorization Specialist II. This is a 03+Months Contract to Hire opportunity with long-term potential and is located in Florida (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID: 25-70093

Pay Range: $18 - $19/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• Shifts: Mon-Fri: 10AM-7PM OR 11AM-8PM EST & 1 Weekend Day (Saturday or Sunday)
• As a part of our hiring process, along with an option to directly connect with a Recruiter or apply online, we now offer a texting option to enhance your candidate experience. Click the link below which contains the job description and a few basic questions that will help you ensure this is a good fit and expedite the shortlisting process or you can directly email me.
  https://hire.glider.ai/connect/85157957
• Aids the utilization management team and maintains ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines
• Supports the authorization review process by researching and documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination
• Verifies member insurance coverage and/or service/benefit eligibility via system tools and aligns authorization with the guidelines to ensure a timely adjudication for payment
• Performs data entry to maintain and update various authorization requests into utilization management system
• Supports and processes authorization requests for services in accordance with the insurance prior authorization list and routes to the appropriate clinical reviewer
• Remains up to date on healthcare, authorization processes, policies and procedures
• Performs other duties as assigned

Key Requirements and Technology Experience: 

• Key Skills; 1-2 years of related experience within a medical facility (doctor’s office, insurance, billing, etc.)
• Knowledge of Medical Terminology
• Authorization Experience
• Insurance knowledge
• Microsoft Office Experience
• Data Entry
• High School Diploma/GED

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

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